A Gordian Knot: Haiti

Photos by Martha RialNatasha Millen, 25, amid the rubble that pinned her leg during the January earthquake near her home in Port au Prince. Millen’s leg was amputated and she recently received a prosthetic leg and rehabilitation at the Hanger Clinic at Hôpital Albert Schweitzer.

Port au Prince, Haiti — A band playing Carribean music greeted us as we entered Toussaint Louverture International Airport. Quite a change from our last trip five years ago, when twin SUVs with dark-​tinted windows met us at a special airport door and armed guards hustled us into the vehicles.

On that trip, returning to the airport days later, a gun battle blocked our progress, and we were escorted through by a U.N. tank with 12 blue-​helmeted soldiers carrying machine guns.

Since then, with the Jan. 12 earthquake and the influx of foreigners, the kidnapping business had apparently fallen on hard times. So on Wednesday, June 23, we walked out of the airport into the 99-​degree heat and the cacophony of the world’s most devastated city. Boys thronged against the chain link fence, shouting “I help you boss. Boss! Boss!” We met our smiling drivers and walked to the vans. And as we pulled onto the road, it seemed for a moment that Port Au Prince was actually in better shape. On the hillsides, however, the blue of the tent cities housing 1.5 million people told a different story. And the next day, the U.S. State Department would issue a Haiti travel warning, mentioning a spike in kidnappings and four murders of Americans leaving the airport.

Our destination was the fertile Artibonite Valley and Hôpital Albert Schweitzer, founded 54 years ago by Gwen and Dr. Larry Mellon and funded in recent years by many Pittsburghers. Shortly out of Port Au Prince, we turned off the cratered roads and onto a beautiful highway built a few years ago by the European community. It cut an hour off the trip and took us way up into the mountains. June is Haiti’s rainy season, and the afternoon showers turn the arid country green.

All along the mountain highway, the road teemed with young people, some sitting, some carrying water and some balancing baskets on their heads. Haiti is among the world’s youngest countries, with a median age of 20 and 65 percent of the population under 21. In the last decade, however, average life expectancy has risen considerably, to 60 years. Some 10 million people live here, on the western third of the island of Hispaniola, where population density is 6.5 times the world average. Roughly half the people are illiterate. About 80 percent live below the poverty line, with more than 50 percent in abject poverty. Average income estimates range from about $400 – $700 a year.

We hadn’t intended to drive at night, but with our flight delayed we descended the mountains at dusk. For the last hour, we drove through village after village in near-​total darkness. Sometimes there were candles, and in the last 30 miles, I counted two electric lights. Yet all along the road, our headlights revealed groups of people, large and small. Evening is the gathering time, we were told, and the road offers the advantage of passing cars that illuminate these parties in the dark.

On our first morning, we hopped in a van with Starry Sprenkle, a former college basketball player from California who leads the hospital’s reforestation program. Our trip five years ago marked its initiation, when Pittsburgher Chris Snavely brought a variety of seedlings. He sought a tree that would grow quickly, help reforest the denuded country and provide a cash crop for Haitians. The deforestation began more than 200 years ago when Napoleon’s troops logged the native mahogany as payment for Haitian independence. It has only accelerated as desperate Haitians hack down trees to sell as charcoal. Without trees, soil erodes, leaving rock. Rains often become flash floods. And the land absorbs less and less water.

To the ordinary person, the tree program seemed quixotic, a noble drop in a roiling ocean. To Sprenkle, however, it was opportunity. And for the past four years, the dauntless Ph.D. candidate in ecology has built what she believes can be a model for Haiti and beyond. Four-​wheel driving over impossible rock roads, she pulled up to a rude, concrete hut on a barren, boulder-​strewn plateau. In a protected area behind the hut lay one of her nurseries, where hundreds of young cedar and mahogany trees grew from seed. Each year, Sprenkle treks into this back country, enrolling 30 people per community in a year-​long program on growing and tending trees. Participants then plant 100 trees on their own land. So far, Sprenkle has spread the program to 34 communities, and she’s adding 10 more this year. If you do the math, that’s more than 100,000 trees going into the ground each year.

We bounced on through the mountains to a thriving stand of young mahogany trees planted in rows, interspersed with corn and millet. “Some people look at this plot and believe it was done with voodoo charms — there’s not a lot of education here,” said Sprenkle. “But we believe we have the right model. We’re making the trees the people’s product, helping them focus on the long term. The amount of money they can make with the trees is five times the national average income. But it takes 10 years, and that’s a long time in a subsistence economy. There’s an expression here: ‘What’s in your stomach is yours.’”

The story of L’ Hôpital Albert Schweitzer is one of the most remarkable in Pittsburgh history. Dissatisfied with his life, the son of the founder of Gulf Oil met with famed humanitarian Dr. Albert Schweitzer and decided to dedicate his life to helping others. He graduated from medical school at 44, and, with his second wife, Gwen Grant Mellon, founded the hospital in 1956 on a former Standard Fruit Company campus.

Since Mrs. Mellon died in 2000, the captain of the $5 million-​a-​year operation has been her son from a previous marriage, Ian Rawson. The tall and charming raconteur has long been the hospital’s front man and chief fundraiser. But for the past year, he has also directed the hospital’s operations, living full-​time in Haiti. Last fall, he came down with both malaria and dengue fever, known as “bone-​crunching fever” for its violent shakes. The combination could easily have killed him, but Rawson survived. He was in Haiti when the quake hit and waves of refugees flooded the hospital. And he’s there now. If it’s a burden, it doesn’t show. Nor does Rawson’s age, 71. “The secret is thinking younger,” he said, with a laugh, stretching out on a couch in the staggering afternoon heat. “I’ve always believed that.”

Rawson made the rounds of the hospital, joking with patients in Creole and leading visitors to the hospital’s most successful new venture, the Hanger Clinic. Outside the clinic building, half a dozen amputees practiced walking with their high-​tech aluminum and titanium legs. Inside the group was larger, and family members tended to loved ones who were getting fitted and taking their first new steps.

A team of prosthetic experts sponsored by Hanger Orthopedic Group and its philanthropic branch, The Hanger Ivan R. Sabel Foundation, has run the operation since Feb. 24. They take molds of the patient’s stump, construct the prosthetics, and teach the Haitians how to use them. They fit some 30 patients a week, 500 since the program began. While they’re at the clinic, patients live in 32-​bed community especially adapted for them, working with physical therapists until they’re ready to start their new lives.

When darkness falls at the Mellon house, the heavy, floor-​to-​ceiling wooden screen doors are maneuvered into place, and a cadre of disparate guests arrives. On this trip, that included two Americans based in the Dominican Republic and their enormous ex-​special forces bodyguard; they sought to build a partnership with Rawson and distribute their special peanut butter that fights infant malnutrition. Also there were a young Turkish woman, who was overseeing a United Nations aid project; Ian’s son Edward and nephew Nico, who were leading U.N.-related mural-​painting and sports projects; and a group of young women serving as nurses and administrators.

And there was Dr. Bart Saxbe, son of the former U.S. Senator and Attorney General Bill Saxbe, who famously likened President Richard Nixon’s Watergate denials to “the man who plays piano at a brothel for 20 years and says he doesn’t know what’s going on upstairs.” Dr. Saxbe had been to the hospital 30 years earlier, and in the intervening years had spent vacations as a surgeon in poor countries around the world. “It’s said that Haiti is the poorest African country,” he remarked. “And I think it’s apt.” Dr. Saxbe and our Pittsburgh companion, Dr. Bill Swartz, treated a variety of patients, including a 4-​month-​old girl, whose face and upper torso were badly burned after she’d been passed over a fire in a voodoo ceremony to cleanse her of evil spirits. It was a replay of a case we saw on the last trip five years ago.

Evenings are a respite from such horrors, and they pass with Haitian beer, rum drinks and dinners of goat meat, rice and platters of local fruit. Then it’s off to bed and the ritual of climbing in and tucking every edge of the mosquito netting carefully under the mattress. When sleep finally comes, it’s despite the heat and the noisy rooster just beyond the screen. Sunrise arrives as a relief at 5:30 a.m., the only part of a summer day when your shirt doesn’t stick to your back.

The biggest thing to hit the Artibonite Valley this summer was the United Nations “Cash for Work” program. Administered by the hospital, the $750,000 program oversaw the hiring of 7,000 residents for one month each at a windfall wage of $90 a month. Similar projects stretched across the land as part of the U.N.’s post-​disaster strategy to inject cash into the flat-​line economy, get work done, and buy peace during trying times.

In the valley, the program included painting murals, starting soccer teams, planting trees and improving roads. It also included cleaning decades of silt and garbage from an irrigation canal that was well built 50 years ago but poorly maintained. From the town of Verrettes to the hospital a few miles away, gangs of men and women of all ages toiled in the heat, digging with picks, shovels and machetes until they reached the canal’s five-​foot-​deep bed. And with each day’s rain, water flowed in the completed portions, escaping through the sluices that functioned to irrigate fields where men planted rice in the wet and fertile fields.

At one spot, a gang worked in the shade, trying to clear a blocked portion between two already cleared sections of the canal. The supervisor was a young man named Jackson, who got the job because he spoke some English. On that Saturday, he explained that the job ended Tuesday and that he and the gang liked their jobs. He asked if I could make the job continue. If it didn’t, they wouldn’t be able to finish the middle and connect the sections. I explained I was there to write a story about the project but that I knew that everyone was hired for one month only.

Jackson asked if they were doing a good job. I said they were but suggested they take the dirt they’d piled in mounds above the canal and put it on the fields. It was very good soil and would help the crops. And if they didn’t move it, the rain would wash it all back down.

Another supervisor approached, and he and Jackson asked again if I could continue the project beyond Tuesday. The persistence made perfect sense. I was a “blanc” (a white), which meant I must have the means to keep the money flowing.

“You’ve seen the power of what you can do when you work together,” I said. “You should keep working even after Tuesday and finish the project. You’re very close, and it will help your community.” The words rang hollow even as I said them, but I thought they needed to be said. Realistically, the people digging in that heat didn’t own the adjacent land and didn’t have wheelbarrows to move those mounds of rich soil from the top of the canal. Come Tuesday, they would no longer get paid. The likely result was that that project and the other U.N. ventures like it would simply end when the money stopped.

After an hour driving in the cool darkness, the contours of the land became visible. And when the sun rose, the green fields of the Artibonite Valley framed by mountains looked a cinematic take of Southeast Asia, beautiful and verdant. We were heading back to Port Au Prince and the airport. By 7 a.m. Sunday, the city bustled. At the airport, an official-​looking man spoke broken English and ushered us past people of all races waiting in line. There was no point saying “no.” The officials all nodded, waving us forward, eager to split the awaiting tip. Some visitors fall in love with Haiti and its people. For others, the prospect of touching back down on U.S. soil can’t come soon enough.

For those who stay behind, the question will be whether the U.N. and dozens of countries will make good on their pledges of billions in aid. And will the aid fundamentally change a country that had failed in virtually every aspect long before January’s 7.0 earthquake? Reconstruction efforts so far have stalled in the face of property disputes in the arcane Haitian system, lack of government, and general chaos. And in the U.S. and beyond, attention has long since shifted from the Caribbean island north to the BP oil spill.

Back in the Artibonite Valley, Hôpital Albert Schweitzer continues to perform its mission, helping the region’s people regardless of Haiti’s circumstances. As we left, Ian Rawson was preparing to take a solitary two-​week sojourn into the mountains. At night, he would cook by a fire and sleep in a one-​man tent in the island’s remote regions. Six decades have passed since he first visited Haiti as a 10-​year-​old boy, with his mother and stepfather. Whether a spiritual dimension lay behind his solo journey is only for Rawson to know. The practical aspect, however, was unmistakable. He would visit the hospital’s far-​flung dispensaries to personally see to it that the system he’s charged with carrying on has what it needs to provide medical care to the people of Haiti.

A journalistic innovator, Heuck has been writing about Pittsburgh for 25 years, as an investigative reporter and business editor at The Pittsburgh Press and Post-​Gazette and as the founder of Pittsburgh Quarterly. His newspaper projects ranged from living on the streets disguised as a homeless man to penning the only comprehensive profile in the latter years of polio pioneer Dr. Jonas Salk to creating a statistical means of judging regional progress that has led to similar projects across the country. Heuck’s work has won numerous national, state and local writing awards. His work has been cited in the landmark media law case “Food Lion vs. ABC news.”

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